Division of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil; Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.
Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina.
Lancet Glob Health. 2024 Oct;12(10):e1600-e1610. doi: 10.1016/S2214-109X(24)00275-4.
Approximately 40% of dementia cases worldwide are attributable to 12 potentially modifiable risk factors. However, the proportion attributable to these risks in Latin America remains unknown. We aimed to determine the population attributable fraction (PAF) of 12 modifiable risk factors for dementia in seven countries in Latin America.
We used data from seven cross-sectional, nationally representative surveys with measurements of 12 modifiable risk factors for dementia (less education, hearing loss, hypertension, obesity, smoking, depression, social isolation, physical inactivity, diabetes, excessive alcohol intake, air pollution, and traumatic brain injury) done in Argentina, Brazil, Bolivia, Chile, Honduras, Mexico, and Peru. Data were collected between 2015 and 2021. Sample sizes ranged from 5995 to 107 907 participants (aged ≥18 years). We calculated risk factor prevalence and communalities in each country and used relative risks from previous meta-analyses to derive weighted PAFs. Pooled PAFs for Latin America were obtained using random effect meta-analyses.
The overall proportion of dementia cases attributed to 12 modifiable risk factors varied across Latin American countries: weighted PAF 61·8% (95% CI 37·9-79·5) in Chile, 59·6% (35·8-77·3) in Argentina, 55·8% (35·7-71·5) in Mexico, 55·5% (35·9-70·4) in Bolivia, 53·6% (33·0-69·3) in Honduras, 48·2% (28·1-63·9) in Brazil, and 44·9% (25·8-61·2) in Peru. The overall PAF for dementia was 54·0% (48·8-59·6) for Latin America. The highest weighted PAFs in Latin American countries overall were for obesity (7%), physical inactivity (6%), and depression (5%).
The estimated PAFs for Latin American countries were higher than previous global estimates. Obesity, physical inactivity, and depression were the main risk factors for dementia across seven Latin American countries. These findings have implications for public health and individually targeted dementia prevention strategies in Latin America. Although these results provide new information about Latin American countries, demographics and representativeness variations across surveys should be considered when interpreting these findings.
None.
全球约 40%的痴呆病例可归因于 12 个潜在可改变的危险因素。然而，拉丁美洲这些风险的归因比例尚不清楚。我们旨在确定 7 个拉丁美洲国家 12 个可改变的痴呆风险因素的人群归因分数（PAF）。
我们使用了来自 7 个具有 12 个可改变的痴呆风险因素（受教育程度较低、听力损失、高血压、肥胖、吸烟、抑郁、社会隔离、缺乏身体活动、糖尿病、过度饮酒、空气污染和创伤性脑损伤）的全国代表性横断面调查的数据。这些调查于 2015 年至 2021 年进行。样本量范围为 5995 至 107907 名参与者（年龄≥18 岁）。我们计算了每个国家的风险因素流行率和共性，并使用之前荟萃分析的相对风险来推导出加权 PAF。使用随机效应荟萃分析获得拉丁美洲的汇总 PAF。
12 个可改变的风险因素导致的痴呆病例在拉丁美洲国家之间的总体归因比例不同：智利的加权 PAF 为 61.8%（95%CI 37.9-79.5），阿根廷为 59.6%（35.8-77.3），墨西哥为 55.8%（35.7-71.5），玻利维亚为 55.5%（35.9-70.4），洪都拉斯为 53.6%（33.0-69.3），巴西为 53.6%（33.0-69.3），秘鲁为 48.2%（28.1-63.9）。拉丁美洲的总体痴呆 PAF 为 54.0%（48.8-59.6）。拉丁美洲国家中最高的加权 PAF 是肥胖（7%）、缺乏身体活动（6%）和抑郁（5%）。
拉丁美洲国家的估计 PAF 高于之前的全球估计值。肥胖、缺乏身体活动和抑郁是七个拉丁美洲国家痴呆的主要危险因素。这些发现对拉丁美洲的公共卫生和针对个人的痴呆预防策略具有重要意义。尽管这些结果提供了关于拉丁美洲国家的新信息，但在解释这些结果时应考虑到调查之间的人口统计学和代表性差异。
无。
